A seemingly high ranking beast in the Destroyer's army (or at least an incredibly powerful one), the Suffering is a repulsive abomination with four arms, a body comprised of human bones with many skulls concentrated at the head and a tongue with numerous, skull-like growths on it. Phenomenally strong, this beast is capable of demolishing an entire squad of Angels with little difficulty. These monsters feed on the corpses of humans and mutate them into the Swarm, a horde of fast-moving zombie-like creatures which they are capable of controlling with their roars.

A single one of these monsters confronted a Hellguard squadron shortly after Death's brief sojourn to Earth, and engaged in combat with the leader of the Hellguard; Uriel. The monster was able to take hits from her holy blade with no apparent damage, and incapacitated her with a single swipe before nearly killing her. However, it fled the battle upon seeing Death.

Death kills several of these monsters whilst exploring Earth and a single Suffering is fought in the penultimate round of the Crucible.

Many of these nightmarish creatures; along with their Swarm, are encountered by Fury on her trek through the shattered Earth. It's essence is required in order to trade equipment upgrades with the demon merchant; Vulgrim. A chosen variant of the Suffering can be found and fought near the building site area of the Black Throne.